Malaysia has been lauded for its successful progress in the fight against the HIV epidemic, as the number of new infections falls.

With new HIV infections dropping to 5,700 cases last year, a dip of 34 per cent from six years ago, Eamonn Murphy, the region’s director for the Joint United Nations Programme on HIV/Aids (UNAids) regional support team for Asia and the Pacific, has called it “a major reduction, which is almost three times that of the regional average”, in an interview with the New Straits Times.

Murphy said this during the four-day 5th Asia Pacific Conference on Public Health organised by Academy of Medicine Malaysia’s College of Public Health Medicine from Sep 10-13.

There are over 100,000 people living with HIV in Malaysia, according to the PT Foundation. Of these, over 90,000 are men while the rest are women, and the number of women with HIV is increasing. So far, 13,000 Malaysians have died from the disease since it was first discovered in the country in 1986.

According to the foundation, the key populations with HIV are injecting drug users, sex workers and transgender men who have intercourse with men. It is often found in people aged between 20 and 39 though middle-aged people are increasingly affected too. Each day, one in 10 Malaysians is infected with HIV.

There have been some notable advances in the treatment of HIV in Malaysia.

For example, 90 per cent of people living with HIV in Malaysia know they had the virus. This, said Murphy, is another significant number as only two-thirds of the people living with HIV in the Asia-Pacific region are aware of their status.

He said Malaysia was “ahead of the curve” as Malaysia has implemented a range of testing options for key populations who are at risk of contracting HIV.

He noted: “The country is on the verge of eliminating cases involving transmission from mother to child.”

According to the United Nations International Children’s Emergency Fund (Unicef), 21,000 babies with HIV are born each year in the Asia-Pacific. If left untreated, said Unicef, women living with HIV have a 15 to 45 per cent chance of transmitting the virus to their children during pregnancy, labour, delivery or breastfeeding.

However, that risk drops to just over 1 per cent if anti-retroviral medicines are given to both mothers and children throughout the stages when infection can occur. “More than 70 per cent of pregnant women living with HIV are accessing services to prevent the onward transmission of the virus,” Murphy said.

“Data from Malaysia indicates that the rate of mother-to-child transmission of HIV is low.”

He added that Malaysia is one of only a few nations in the region being considered for formal certification of the elimination of mother-to-child transmission. According to Avert, a leading non-profit dedicated to information about HIV and Aids globally, Malaysia has made substantial progress with its prevention of mother-to-child transmission, increasing treatment coverage from 68.5 per cent in 2012 to nearly 85.5 per cent in 2013.

Thailand was the first country in the region to be recognised for eliminating HIV transmission from mother to child last year.

On injecting drug users, a demographic that is highly vulnerable to HIV infection, Murphy said data shows that 16.3 per cent of new cases are due to the sharing of contaminated needles and syringes among drug addicts.

“In 2016, the Aids Epidemic Model estimated that 41 per cent of adult new HIV infections were among people who inject drugs. However, through opioid substitution therapy and needle and syringe programmes, the government has made an effort to reverse the situation and the number of new infections among people who inject drugs has declined 37 per cent in the past six years.”

The next highest category for new transmissions was men who have sex with other men (8.9 per cent), followed by female sex workers (7.3 per cent) and transgender people (5.6 per cent).

Nonetheless, there is a need for more access to treatment, said Murphy.

“Though Malaysia has taken big steps forward, data showed only 37 per cent of people living with HIV are accessing life-saving treatment,” he said. “That is significantly lower than the regional average.”

“Being on treatment has the double dividend of ensuring a person living with HIV is healthy and preventing the transmission of virus to their partners,” said Murphy. “Forty-seven per cent of all HIV-positive people in the region are accessing treatment. This is less than the 53 per cent of people living with HIV on treatment globally,” he told the conference.

UNAids, he said, believes that the path to ending Aids requires strong partnerships between governments and communities, focusing on innovative approaches for reaching populations most at risk and integrating HIV with other disease programmes.

Murphy said such a plan could be applied to medical crises such as Hepatitis C, Zika and Ebola.

“Though we have experienced unprecedented success in the region, we are seeing what happens when we take the foot off the pedal. The region used to be a leader, but is now lagging behind global trends.

He called on countries to re-energise efforts to reduce new HIV/Aids epidemics since “the virus does not take a vacation”.

“I am counting on Malaysia, which is one of 10 countries in the region, accounting for more than 95 per cent of new infections, to play a key role in relegating Aids to the history books.”

According to the United Nations, the other countries are India, China, Indonesia, Pakistan, Vietnam, Myanmar, Papua New Guinea, the Philippines and Thailand.